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Public Housing
Assistance

We are at your service

At Continuum Care Center, we believe that affordable housing is a fundamental human right. We are dedicated to advocating for accessible and equitable housing solutions for all individuals and families. Please review, sign and submit the forms below to begin the process. We look forward to working with you!

Saint Paul PHA Eligibility Verification

Date
Month
Day
Year
Date of Birth
Month
Day
Year

Electronic Signature Consent

By typing my name below and submitting this form electronically, I acknowledge and agree that my electronic signature is the legal equivalent of my handwritten signature. I understand that this electronic signature has the same validity and enforceability as a traditional signature in accordance with the U.S. Electronic Signatures in Global and National Commerce Act (ESIGN) and the Health Insurance Portability and Accountability Act (HIPAA).

 

I consent to the collection and disclosure of my protected health information (PHI) as described in this document, and I acknowledge that I have received and reviewed the Notice of Privacy Practices.

Signature and checked boxes are required to submit this form.

Click below if you prefer to fill out these forms manually and upload them to your case manager. 

Upload signed documents

Let’s Work Together

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